Posts filed under ‘Infecciones virales’

Measles virus infection diminishes preexisting antibodies that offer protection from other pathogens.

Measles Virus Infection Negatively Affects Host Immune Status

New evidence shows that measles infection decreases the breadth and titers of preexisting antibodies to a wide variety of pathogens

SOURCE

Science. November 1, 2019 V.366 N.6465 P.599-606.

Mina MJ1,2,3, Kula T4,2, Leng Y4, Li M2, de Vries RD5, Knip M6,7, Siljander H6,7, Rewers M8, Choy DF9, Wilson MS9, Larman HB10, Nelson AN11, Griffin DE11, de Swart RL5, Elledge SJ1,2,12.

Author information

1 Division of Genetics, Brigham and Women’s Hospital, Howard Hughes Medical Institute, Boston, MA 02115, USA. selledge@genetics.med.harvard.edu  mmina@hsph.harvard.edu

2 Department of Genetics, Harvard Medical School, Boston, MA 02115, USA.

3 Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA.

4 Division of Genetics, Brigham and Women’s Hospital, Howard Hughes Medical Institute, Boston, MA 02115, USA.

5 Department of Viroscience, Postgraduate School of Molecular Medicine, Erasmus MC, University Medical Centre Rotterdam, 3015 CN, Rotterdam, Netherlands.

6 Children’s Hospital, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland.

7 Research Program for Clinical and Molecular Metabolism, University of Helsinki, 00014 Helsinki, Finland.

8 Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Denver, CO 80045, USA.

9 Genentech Inc., South San Francisco, CA 94080, USA.

10 Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.

11 W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.

12Program in Virology, Harvard Medical School, Boston, MA 02115, USA.

Abstract

Measles virus is directly responsible for more than 100,000 deaths yearly. Epidemiological studies have associated measles with increased morbidity and mortality for years after infection, but the reasons why are poorly understood. Measles virus infects immune cells, causing acute immune suppression. To identify and quantify long-term effects of measles on the immune system, we used VirScan, an assay that tracks antibodies to thousands of pathogen epitopes in blood. We studied 77 unvaccinated children before and 2 months after natural measles virus infection. Measles caused elimination of 11 to 73% of the antibody repertoire across individuals. Recovery of antibodies was detected after natural reexposure to pathogens. Notably, these immune system effects were not observed in infants vaccinated against MMR (measles, mumps, and rubella), but were confirmed in measles-infected macaques. The reduction in humoral immune memory after measles infection generates potential vulnerability to future infections, underscoring the need for widespread vaccination.

FULL TEXT

https://science.sciencemag.org/content/366/6465/599.long

PDF

https://science.sciencemag.org/content/sci/366/6465/599.full.pdf

November 18, 2019 at 7:04 pm

Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America.

Am J Respir Crit Care Med. October 1, 2019  V.200 N.7  e45-e67.

Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, et al.

Background

This document provides evidence-based clinical practice guidelines on the management of adult patients with community-acquired pneumonia.

Methods

A multidisciplinary panel conducted pragmatic systematic reviews of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations.

Results

The panel addressed 16 specific areas for recommendations spanning questions of diagnostic testing, determination of site of care, selection of initial empiric antibiotic therapy, and subsequent management decisions. Although some recommendations remain unchanged from the 2007 guideline, the availability of results from new therapeutic trials and epidemiological investigations led to revised recommendations for empiric treatment strategies and additional management decisions.

Conclusions

The panel formulated and provided the rationale for recommendations on selected diagnostic and treatment strategies for adult patients with community-acquired pneumonia.

 

Este documento proporciona pautas de práctica clínica basadas en evidencia sobre el manejo de pacientes adultos con NAC.

Métodos

Un panel multidisciplinario realizó revisiones sistemáticas pragmáticas de la investigación relevante y aplicó la metodología de calificación de recomendaciones, evaluación, desarrollo y evaluación para recomendaciones clínicas.

Resultados

El panel abordó 16 áreas específicas para recomendaciones que abarcan preguntas sobre pruebas de diagnóstico, determinación del sitio de atención, selección de terapia ATB empírica inicial y decisiones de manejo posteriores. Aunque algunas recomendaciones permanecen sin cambios con respecto a la guía de 2007, la disponibilidad de resultados de nuevos ensayos terapéuticos e investigaciones epidemiológicas condujo a recomendaciones revisadas para estrategias de tratamiento empírico y decisiones de manejo adicionales.

Conclusiones

El panel formuló y proporcionó la justificación de las recomendaciones sobre estrategias seleccionadas de diagnóstico y tratamiento para pacientes adultos con NAC.

FULL TEXT

https://www.atsjournals.org/doi/10.1164/rccm.201908-1581ST#_i6

PDF

https://www.atsjournals.org/doi/pdf/10.1164/rccm.201908-1581ST

November 15, 2019 at 7:59 am

A New Perspective on HIV Diagnostics: Reinterpretation in the Age of Early Treatment

Clin. Microbiol. October 2019 V.57 N.10

Commentary

Early treatment of HIV infection with antiretroviral therapy in recently identified HIV-infected individuals reduces viral replication and decreases the risk of transmission.

The screening and supplemental, confirmatory assays used to identify infection are influenced by early treatment and may obscure a clear diagnosis of HIV infection.

In this issue of the Journal of Clinical Microbiology, Manak et al. demonstrate the impact of antiretroviral therapy on the evolution of biomarkers that have traditionally been used for identifying HIV infection

abstract

https://jcm.asm.org/content/57/10/e00978-19.abstract?etoc

PDF

https://jcm.asm.org/content/jcm/early/2019/07/26/JCM.00978-19.full.pdf

September 24, 2019 at 3:18 pm

Interventions to Reduce Measles Virus Exposures in Outpatient Health Care Facilities — New York City, 2018

MMWR Sep 13, 2019 V.68 N.36 P.794-792

Strengthening health care facility infection control is crucial to preventing infectious disease transmission.

Guidelines to prevent or minimize airborne pathogen spread in outpatient health care facilities exist (1); however, few reports describe practical implementation when engineering controls, such as recommended airborne infection isolation rooms (negative pressure rooms), are unavailable* (2).

On September 30, 2018, a person with measles, a highly contagious respiratory illness characterized by fever and rash, that is spread by airborne transmission, was detected in New York City (NYC),† and as of December 10, 42 laboratory or epidemiologically linked cases had been confirmed.

By September 3, 2019, with 654 confirmed cases, this measles outbreak had become the largest in the United States since 1992, well before endemic domestic measles transmission was declared eliminated in 2000§,¶ (3,4).

Interventions used in 15 outpatient health care facilities to attempt to prevent health care facility exposure from patients with suspected measles were evaluated….

FULL TEXT

https://www.cdc.gov/mmwr/volumes/68/wr/mm6836a2.htm?s_cid=mm6836a2_w

PDF

https://www.cdc.gov/mmwr/volumes/68/wr/pdfs/mm6836a2-H.pdf

September 20, 2019 at 3:54 pm

ARGENTINA – Confirmación de tres nuevos casos de sarampión en niños. Alto riesgo de transmisibilidad

ACTUALIZACIÓN EPIDEMIOLÓGICA 13/0/2019 – Ministerio salud Nación

En virtud de la situación epidemiológica regional y local respecto a la confirmación de tres casos de

sarampión en niños residentes de la Ciudad Autónoma de Buenos Aires y la Provincia de Buenos Aires, la

Secretaria de Gobierno de Salud emite la siguiente actualización…..

TEXTO COMPLETO

https://www.argentina.gob.ar/sites/default/files/sarampion_13_septiembre_2019.pdf

 

– – –

September 14, 2019 at 9:39 am

Sep. 11, 2019 Confirmación de dos casos de sarampión en viajeros. Alto riesgo de transmisibilidad Ministerio Salud Argentina

ACTUALIZACION EPIDEMIOLOGICA

En virtud de la situación del brote de sarampión en Brasil y otros países de la región y el mundo, y la confirmación de dos casos en turistas extranjeros arribados a España provenientes de Argentina con diagnóstico de sarampión, la Secretaria de Gobierno de Salud emite la siguiente actualización …

Boletín completo

https://www.argentina.gob.ar/sites/default/files/sarampion_alerta-11-09-2019.pdf

September 12, 2019 at 7:54 am

Confirmación de caso de sarampión en Ciudad de Buenos Aires con antecedente de viaje a Brasil

ALERTA EPIDEMIOLÓGICA 4/Septiembre/2019 – SE 36

En virtud de la situación de brote de sarampión en Brasil y otros países de la región y el mundo, y la confirmación de un caso en un ciudadano argentino con antecedente de viaje, la Secretaría de Gobierno de Salud emite el presente alerta:

SITUACIÓN ACTUAL

Se confirmó un caso de sarampión en un hombre de 44 años residente en la Ciudad de Buenos Aires, atendido en efector privado, con antecedente de viaje a Brasil, que comenzó con fiebre el día 10 de agosto, agregando exantema cuatro días después. El caso se confirmó por serología (IgM positiva en suero) y seroconversión de IgG, así como RT-PCR positiva en orina. Las muestras fueron procesadas por el efector privado y se confirmaron en el Laboratorio Nacional de Referencia ANLIS Carlos G. Malbrán. Se encuentran en desarrollo las pruebas para identificación de genotipo y linaje viral. La fuente de infección está en investigación. Se iniciaron acciones de prevención y control en los contactos del caso, quienes se encuentran en seguimiento…

ARTICULO COMPLETO

https://www.argentina.gob.ar/sites/default/files/2019-09-04-alerta-sarampion.pdf

September 9, 2019 at 3:10 pm

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